Individual provider Active NPI

Lynette Marla Santiago, D.P.M.

  • Foot Surgery Podiatrist
  • Virginia Beach, VA
National Provider Identifier
1700840741
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0103300943 Issued in VA
Practice address
665 Newtown Rd
Virginia Beach, VA 23462-1683
Phone
(757) 490-1226
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X 0103300943 VA Primary

Addresses

Primary practice location

665 Newtown Rd
Virginia Beach, VA 23462-1683

Mailing address

6477 College Park SQ
Ste 108
Virginia Beach, VA 23464-3611
Phone (757) 222-4991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060425000749 VA Practitioner - Podiatry 7618987306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Podiatry IncGroup PAC ID 9830196468, 2 clinicians

Practice addresses (Care Compare)

6477 College Park SQ
Suite 106
Virginia Beach, VA 23464-3611
Phone (804) 840-0512

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue19
Removal of nail tissue973
Removal or shaving of skin growth36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0103300943VAMDFoot Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Medoptions Behavioral Health Assoc, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1700840741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6477 COLLEGE PARK SQ",
            "address_2": "STE 108",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234643611",
            "telephone_number": "757-222-4991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 NEWTOWN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234621683",
            "telephone_number": "757-490-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "LYNETTE",
        "middle_name": "MARLA",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "VA",
            "license": "0103300943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.